This article examines criticisms of cost-benefit analysis and the contingent valuation method from methodological and moral philosophical perspectives. Both perspectives argue that what should be elicited for public decisions are attitudes or values, not preferences, and that respondents should be treated as citizens and not consumers. The moral philosophical criticism argues in favour of deliberative approaches over cost-benefit analysis. The methodological perspective is here criticized for overemphasizing the importance of protest responses and anomalies and biases in contingent valuation, and for (...) failing to provide the necessary information needed to make public decisions over the allocation of scarce goods. The moral philosophical perspective is criticized for: failing to provide criteria for distinguishing between values and preferences, assuming impartiality requires expression of values and not preferences; failing to recognize the diversity of forms of expression of values, including expression of values through monetary evaluation; and assuming that cost-benefit analysis is necessarily an implementation of a utilitarian political philosophy. The article concludes by showing that deliberative decision-making mechanisms can be overly demanding on citizens, and argues for greater openness in the potential moral justifications of cost-benefit analysis. Key Words: cost-benefit analysis values preference aggregation democracy willingness to pay. (shrink)
This paper explores some aspects of the concept 'logic' and its relation to moral voice, and argues that Menssen uses it too narrowly in her respone to Orr's "Just the Facts. Ma'am" and the work of Carol Gilligan. Grounded in the work of the later Wittgenstein, it is argued that formalized logic misses much of natural logic: the concept of 'moral talk' is developed to theorize Gilligan's ethic of care; it is argued that this form of moral deliberation is not (...) argumentation in the formal sense; and the relationship between logic and epistemology is explored through the consideration of moral talk as a language-game which is woven into gendered forms of life. Finally, it is argued that the notion of a universal logic is the product of an oppressivc patriarchal culture and should not be defended by feminists. (shrink)
Health-related Quality of Life measures have recently been attacked from two directions, both of which criticize the preference-based method of evaluating health states they typically incorporate. One attack, based on work by Daniel Kahneman and others, argues that ‘experience’ is a better basis for evaluation. The other, inspired by Amartya Sen, argues that ‘capability’ should be the guiding concept. In addition, opinion differs as to whether health evaluation measures are best derived from consultations with the general public, with patients, or (...) with health professionals. And there is disagreement about whether these opinions should be solicited individually and aggregated, or derived instead from a process of collective deliberation. These distinctions yield a wide variety of possible approaches, with potentially differing policy implications. We consider some areas of disagreement between some of these approaches. We show that many of the perspectives seem to capture something important, such that it may be a mistake to reject any of them. Instead we suggest that some of the existing ‘instruments’ designed to measure HR QoLs may in fact successfully already combine these attributes, and with further refinement such instruments may be able to provide a reasonable reconciliation between the perspectives. (shrink)
The term "third wave" within contemporary feminism presents some initial difficulties in scholarly investigation. Located in popular-press anthologies, zines, punk music, and cyberspace, many third wave discourses constitute themselves as a break with both second wave and academic feminisms; a break problematic for both generations of feminists. The emergence of third wave feminism offers academic feminists an opportunity to rethink the context of knowledge production and the mediums through which we disseminate our work.
It seems intuitive to the believer that God intended through instruction in the Law to define morality, intended to lead humankind to “the right and the good.” Further, God's love for humankind, exemplified by the incarnation, atonement and teachings of Jesus, and empowered by the Holy Spirit, should lead to a better world. Indeed, the Christian worldview is a coherent and valid way to look at bioethical issues in public policy and at the bedside. Yet, as this paper explores, in (...) a pluralistic society such as the United States, it is neither possible nor desirable for Christians to try to force their views on others. Still, it is obligatory for Christians to stand up and articulate their views in the public square. We should try to persuade others using either prudential or moral arguments. While we must be willing to live with “the will of the people,” at the same time, we must not be intimidated into accepting the position that our voice is not valid because it has a religious basis. (shrink)
The use of technology in marketing has become an increasingly important competitive tool in developing and maintaining efficient and productive customer relationships. However, the ethics of using this technology has received little attention. This study investigates how and if marketing organizations are adapting their ethics policies to incorporate use of sales technology (ST). Based on in-depth interviews with executives from a variety of highly regulated to nonregulated business-to-business and business-to-consumer industries, our results show that, although most organizations indeed have codes (...) of ethics, there appears to be a gray area of how these codes address ST. Further, it appears that monitoring the ethical use of ST varies and can be a frustrating and time-consuming issue for marketing and sales executives. Implications of our findings are discussed for the benefit of marketing practitioners, ethics managers, and researchers. (shrink)
Requests by patients or their families for treatment which the patient's physician considers to be "inappropriate" are becoming more frequent than refusals of treatment which the physician considers appropriate. Such requests are often based on the patient's religious beliefs about the attributes of God (sovereignty, omnipotence), the attributes of persons (sanctity of life), or the individual's personal relationship with God (communication, commands, etc). We present four such cases and discuss some of the basic religious tenets of the three Abrahamic faith (...) traditions as they relate to such requests. We suggest that religious reasons for requesting "inappropriate" treatment are "special" and deserve serious consideration. We offer guidance to assist clinicians and clinical ethicists as they attempt to resolve these conflicts, emphasising the importance of understanding the religious beliefs of the patient/surrogate and suggesting the assistance of a religious interpreter. We suggest open discussion with patients and families of both the clinical situation and the theological basis for these requests. We also suggest that clinicians use additional religious doctrines or principles from patients' own traditions to balance the reasons behind the requests. We conclude that most persistent requests for "inappropriate" treatment should be honoured. (shrink)
A physician’s long-established right to refuse to provide a requested service based on his or her moral beliefs is being challenged. Some authors suggest that physicians should not be licensed if they are unwilling to provide all legal services. Others would grant them the right to refuse, but require them to refer to a willing professional. What are the limits of a physician’s right to refuse? When such a right is claimed on moral grounds, what residual obligations does the physician (...) have to the patient? How should the profession (or society) decide when a moral claim to a right to refuse is justified? (shrink)
Surveys and routine clinical procedures applied in research protocols are typically considered only minimally risky to participants. The apparent benign nature of "minimal risk" tasks increases the chance that investigators and Institutional Review Boards (IRBs) will overlook the probability that clinical tools will identify signs, symptoms, or definitive test results that are clinically-relevant to subjects' welfare. "Minimal risk" procedures may also pose a particular hazard to participants in clinical research by increasing the therapeutic misconception because the tasks mimic clinical care (...) and are often conducted in clinical settings. Investigators should anticipate which measures could yield clinically-important findings and should describe explicit plans for data monitoring, disclosure, and follow-up. Protocols that include reliable and valid clinical measures should prompt a more detailed risk assessment by the IRB, even when the tasks meet the regulatory criteria for minimal physical, psychological, or emotional risk. (shrink)
Two Lagrangians L and L′ are equivalent if the equations of motion derived from them have the same set of solutions. In that case, a matrix Λ may be defined which has the property that the trace of any analytic function of Λ is a constant of the motion. We extend this trace theorem to the case of classical field theory and discuss some of the implications for quantum theory and for procedures for finding equivalent Lagrangians.
Interest in the retrieval of organs from non-heart-beating cadaver donors has been rekindled by the success of transplantation of solid organs and the insufficient supply of donor organs currently obtained from heart-beating cadaver donors. There are currently two retrieval techniques being evaluated, the in situ cold perfusion approach and the controlled death approach. Both, however, raise ethical concerns. Reanimation is a new method which has been used successfully in animals. We believe this new approach overcomes the ethical objections raised to (...) these other methods. (shrink)
Background Physicians face competing values of truth-telling and beneficence when deception may be employed in patient care. The purposes of this study were to assess resident physicians' attitudes towards lying, explore lie types and reported reasons for lying. Method After obtaining institutional review board review (OSR# 58013) and receiving exempt status, posts written by Loma Linda University resident physicians in response to forum questions in required online courses were collected from 2002 to 2007. Responses were blinded and manually coded by (...) two investigators using NVivo software. Qualitative and quantitative analyses of the data were performed with links to various attributes. A 95% binomial proportion CI was used to analyse the attribute data. Results The study found that the majority of residents (90.3%) would disclose the truth about medical errors. Similarly, many residents (55.7%) would disclose the truth regarding unanticipated events, especially if the error was serious enough to result in a malpractice suit (74.7%). However, many residents (40.9%) would not reveal a near miss event because they believe it has no impact on patient health. Some residents (47.3%) would deceive the insurance company for additional patient benefits. Of those willing to lie, only a small group (4.2%) gave self-serving reasons. Conclusions This study demonstrates that the ethical issues related to deception that trouble attending physicians also exist at the resident physician level. Residents primarily lie for altruistic reasons and rarely for egoistic or self-serving purposes that may or may not result in harm to patients, insurance companies and/or physicians themselves. (shrink)